MEDICARE: HEALTHCARE SOLUTIONS MEDICAL SUPPLY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164405825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE SOLUTIONS MEDICAL SUPPLY, LLC

Provider Business Mailing Address
First Line	:	116 S ADAMS ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-4511
Country	:	US
Telephone Number	:	804-732-7625
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 S ADAMS ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-4511
Country	:	US
Telephone Number	:	804-732-7625
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KIM BRANDVEEN
Credential	:
Telephone Number	:	804-732-7625

Provider Enumeration Date	:	11/26/2005
Last Update Date	:	02/13/2008

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